Deans' stroke musings: Involvement of the Right Lentiform Nucleus is an Independent Predictor of Poor Outcomes in Large Vessel Occlusion Strokes with Small Infarct Volumes

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, September 2, 2025

Involvement of the Right Lentiform Nucleus is an Independent Predictor of Poor Outcomes in Large Vessel Occlusion Strokes with Small Infarct Volumes

You described something BUT INCOMPETENTLY DID NOTHING TO SOLVE THE PROBLEM! YOU'RE FIRED!

In what multiverse do you live where predicting poor outcomes helps survivors recover?

Involvement of the Right Lentiform Nucleus is an Independent Predictor of Poor Outcomes in Large Vessel Occlusion Strokes with Small Infarct

https://doi.org/10.1016/j.clineuro.2025.109137 Get rights and content

Highlights

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Although a small final infarct volume (FIV) was achieved following successful thrombectomy, approximately 30% of patients still experienced poor outcomes at 3 months.
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There is no universally accepted definition of a small FIV; in this study, two thresholds were used: <30 ml and <10.88 ml, the latter representing the 25th percentile of the cohort.
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Independent predictors of unfavorable outcomes included older age, coronary artery disease (CAD), a history of previous stroke, cardioembolic stroke etiology, and the number of mechanical thrombectomy (MT) attempts.
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Analysis using AI-based software to assess affected ASPECTS regions identified the right lentiform nucleus as an independent predictor of poor outcomes in patients with FIV ≤30 ml and also those with FIV ≤10.88 ml.

Abstract

Background

Final infarct volume (FIV) is a strong predictor of stroke outcomes. Although smaller FIV are associated with better outcomes, many patients fail to achieve functional independence. We aimed to identify poor outcome predictors in patients with anterior large vessel occlusion stroke (LVOS) who underwent mechanical thrombectomy (MT) and had small FIV.

Methods

We reviewed a prospective MT database from October 2010 to December 2020. Patients with intracranial ICA or MCA-M1/2 occlusions, premorbid mRS ≤2, underwent MT, and had FIV ≤30 ml on follow-up MRI were included. The cohort was divided into: good (mRS≤2) and poor (mRS>2) outcomes at 90 days. Multivariable analysis identified the poor outcome predictors and the association between e-ASPECTS regions and outcomes.

Results

Among 2370 thrombectomies, 555 had FIV ≤30 ml. After exclusions, 398 patients were analyzed. The median age was 65 years, with 54% female, median NIHSS was 15, and the median ASPECTS was 9. Poor outcome was associated with older age, female sex, atrial fibrillation (AF), hypertension (HTN), coronary artery disease (CAD), and prior strokes. Right lentiform nucleus involvement is an independent predictor of poor outcome in patients with small FIV, along with age, CAD, cardioembolic stroke, number of MT attempts and FIV.

Conclusion

Involvement of right lentiform nucleus is an independent predictor of poor outcomes in LVOS with small FIV. Other predictors included age, CAD, cardioembolic stroke, the number of passes during MT, and FIV. Future strategies are needed to improve outcomes in these patient populations.

Deans' stroke musings